Month: December 2016

Dustin Burrows is the representative for District 83, which includes Lubbock and much of the South Plains. Discussing his priorities for his second legislative session on “Good Day Lubbock,” he said he has filed several bills which include one that should provide more funding for rural school districts.

The Republican also talked about the incoming Trump administration’s impact on the state budget, and whether he would support a statewide ban on texting while driving.

In the mental health profession, prescription privileges are limited to licensed psychiatrists. The Lubbock Republican filed a bill Dec. 13 that would change that.

“I’ve heard from multiple groups we have a lack of numbers of psychiatrists available, and part of the solution is to allow highly-trained psychologists to prescribe medication to their patients,” he said.

Burrows’ proposal, House Bill 593, would allow psychologists to prescribe medication if they’ve met certain criteria. Before they independently write prescriptions, those mental-health providers would have to complete two years of biomedical sciences training, a nationally standardized exam in psychopharmacology and a year of supervision by a physician.

“I support this bill because it’s going to provide more of what the citizens of Texas need, which is appropriate mental health medications,” Dr. Cheryl Hall said. From her office in Southwest Lubbock, the clinical psychologist described a patient demand for mental-health medication and a shortage of psychiatrists.

The Lone Star State’s psychiatric community, on the other hand, has concerns.

“We are very much opposed to this,” said Dr. Debra Atkisson in a phone interview. “It’s unsafe for patients — it really is.”

Atkisson is chairwoman of the Federation of Texas Psychiatry and a practicing psychiatrist in Fort Worth.

Two professions

Pychologists are professionals who has completed a doctorate in the psychological field. Psychiatrists are medical doctors who specialize in mental disorders.

Atkisson, for instance, graduated in 1986 from Texas Tech’s medical school, then underwent four years of training in mental health. Next came two extra years training in child and adolescent psychiatry.

But you can’t become licensed overnight as a clinical psychologist, either. The doctorate can take about six years; training for presciption privileges would take an extra three years.

“We take very intensive training,” Hall said.

Atkisson considers medical school graduation a major difference between the two professions.

“I very much respect my colleagues in psychology — they’re excellent in providing talk therapy and doing psychological testing — but they are not trained to provide medical care … They have half the number of years of training we do, and their training is based on very different things.”

Atkisson emphasized the potential for misdiagnosis if a mental health professional lacks knowledge of overall medicine.

For example, she recalled a case in which a psychologist colleague diagnosed a 10-year-old boy with attention-deficit hyperactivity disorder, and told his mother he needed Ritalin. Because the psychologist was not legally allowed to write the prescription, she referred the family to Atkisson.

Atkisson’s exam led her to suspect the child’s difficulty in focus and attention could be caused by a brain disease or seizure disorder, so she referred him to a pediatric neurologist.

The neurologist found the cause of his ADHD-like behavior was a brain tumor. The neurologist was relieved the boy did not take Ritalin.

The scare reinforced Atkisson’s support for comprehensive medical knowledge for prescription privileges.

But while psychiatrists worry their counterparts in psychology don’t have enough medical training to prescribe medicine, those psychologists fear too many prescriptions for mental-health medication come from doctors with limited background in mental health.

Dr. Michael Ratheal, a Lubbock clinical psychologist, recently responded to a call from the local medical school’s pediatric department. The erratic behavior of a patient, an 8-year-old girl, at first seemed synonymous with a movement disorder. Ratheal spent time with the patient, then offered a correct diagnosis: paranoid schizophrenia.

Ratheal and Hall can only speculate the time, hassle and taxpayer dollars they could save by writing a prescription for the girl’s treatment themselves.

“I would have got her on medicine immediately, and she would not have to go to the hospital, which is traumatic and unnecessary,” Hall said.

Shortage

Ratheal and Hall point out that in the military and the four states that already allow prescription privileges to trained psychologists — New Mexico, Louisiana, Illinois and Iowa — those psychologists have received no malpractice suits.

“Basically, there’s no evidence that we are not safe and effective providers,” Hall said.

Hall and Ratheal also clarified if the bill passes, they will not prescribe opioids.

The situation with Ratheal’s young schizophrenic patient gets worse: Her family had been in the process of moving to a rural Panhandle county where no psychiatrists are in practice.

And in locales with practicing pyschiatrists, seeing one isn’t always quick. A spokeswoman from Texas Tech Physicians Psychiatry, for instance, told A-J Media her clinic has a three-month wait for new patients. “There’s a crisis in the state right now — there just aren’t enough psychiatrists to go around, and they’re overwhelmed,” Hall said.

Texas psychiatrists say the solution, though, is to recruit more psychiatrists.

Other ideas could include the collaboritive care model, in which professionals in areas work closer together, and telemedicine, in which patients videoconference with doctors. “We have a blueprint already; it’s just a matter of the Legislature using what we already have in place and getting appropriate funding for it,” Atkisson said.

With the state and national elections behind us and the New Year around the corner, I wanted to provide you a brief update on the legislative priorities I will be focusing on during the 85th legislative session. But first, I want to thank you for your vote and your continued support. Elisabeth and I recently welcomed our third child, and my oldest just started kindergarten. My children are a constant reminder to me that all of us must work together to insure that you, your children and grandchildren continue to live in the greatest state in the Nation.

Perhaps one of the most enjoyable aspects of being your State Legislator is visiting with you in my office or at a local service organization meetings, farm bureau meetings, community forum, Co-op Gins or town hall. I am grateful to those of you who answered my questionnaire on the topics you believe to be the most important. I read those questionnaires and your thoughts have helped shaped my legislative agenda. During public events and in my office, I have listened carefully when issues are shared. I am acutely aware that laws and regulations affect each and every one of us, both positively and negatively. I am committed to fighting against over regulation and unfunded mandates that keep our economies from growing. The Legislature must continue to not get in the way of the private sector creating jobs and growing the economy.

KEY ISSUES GOING INTO SESSION

Governor Abbott and both Senate and House Leadership see public education funding, fiscal discipline, support of law enforcement and improving Child Protective Services as key issues going into Session. I look forward to supporting the Governor and Speaker’s legislative efforts to positively affect these issues. Additionally, I am hopeful that the legislature will address TRS-Care reform. Our state’s teachers are one of the most valuable resources we have – and, to that end, financial pitfalls with regards to their retirement funds must be addressed.

Across House District 83, I have heard your voices loud and clear – and your thoughts and concerns have helped me to effectively create legislation concerning the following issues:

Prior to and during the course of the Legislative session, I will provide you with regular updates on the progress of bills focusing on these issues. Detailed explanations of the bills will be posted on the Burrows4TX website.

THE STATE BUDGET

Going forward into the 85th Session, it is important to recall that the 84th Legislature approved a $209.4 billion biennial budget, which represented an all funds increase of 3.6%. It was a conservative budget, and spending was less than available revenue and less than spending limit; there is an estimated $4.2 billion in general revenue unspent and the Legislature did not access the Rainy Day Fund. A Supplemental Appropriations Bill of $2.1 Billion remains under the spending limit, but only $600 million is undedicated general revenue. The current balance of the State’s Rainy Day fund is approximately $10.4 billion, which was lower than $11.1 billion predicted. The State’s Highway Fund and Rainy Day Fund bear most of lost energy tax revenue. The largest State general revenue fund source is sales taxes, which, unfortunately, are down 2.27% from 2015.

HOW TO CONTACT ME

When the 85th Legislative Session begins in January, I will continue to regularly update you via email newsletters, my Facebook Page and the Burrows4TXwebsite. You can also follow me on Twitter (@Burrow4TX). I welcome your constant feedback and comments. You can email me atDustin.Burrows@house.texas.gov; or telephone my State Capitol Office at (512) 463-0542.

Due to a shortage of psychiatrists in Texas, right now, more than 80 percent of mental health medications are prescribed by primary care physicians or E.R. doctors, resulting in long wait times and higher costs for the patient.

Burrows says as a member of the House County Affairs Committee, he’s heard a lot about how jails, for instance, could benefit from this bill.

“If you look at our county jails and right now they have become the de facto mental health facilities,” he said. “And so you’ve got to have people who are actually in the jails that can help treat them and we have a shortage of psychiatrists, so hopefully this bill allows some new people to go in and do this and deal with patients who they’re already dealing with and have the background to do it.”

Psychologist Cheryl Hall says the bill would help those with mental health issues who live in underserved and rural areas as well.

“My patients are going to benefit from this because they’re going to be able to get the medication that they need in a timely manner which will help their treatment outcome,” she said.

Under the bill, only mental health medications would be able to be prescribed by the specially trained psychologists.

Smaller school districts in Texas are pushing lawmakers to alter a piece of the way the Lone Star State funds schools. Some districts including, Slaton Independent District, believe that the public school funding model penalizes them just for being smaller districts, putting their students at a disadvantage. It appears at least one Texas legislator has heard their frustration: State Representative Dustin Burrows (District 83) filed a bill Monday to remove those penalties.

He explained that the laws which established the penalties were enacted in the 1980’s in an effort to consolidate school districts.

“A lot of people wanted to try to force some of these districts into consolidation, it was probably a lot of members who probably don’t live in these districts and don’t understand and appreciate how great of a job these rural school districts do in educating our kids,” Burrows explained.

He’s been involved with efforts in the past to try changing this policy. His focus is not on altering the way that Texas schools are funded, but rather on getting rid of the “adjustment” which requires that small school districts of less than 300 square miles receive less state funding. The penalty started off as a 25% adjustment, Burrows said, currently the adjustment is up to over 37%.

“It hurts our small rural schools at the end of the day, it’s something I hope we can fix this upcoming session,” Burrows said.

He believes his bill will do away with an outdated, punitive adjustment.

Burrows said that many small rural school districts have come forward to ask for his help in changing this policy, including Slaton ISD.

This is far from the first time that Texas Public schools have opposed the state funding system. Over 600 Texas schools sued in opposition of state funding, but the Texas Supreme Court upheld the funding policies.

“Our Byzantine school funding ‘system’ is undeniably imperfect, with immense room for improvement. But it satisfies minimum constitutional requirements,” Justice Don Willett wrote in the opinion.

Julee Becker, superintendent of Slaton ISD said that this lack of funding is the biggest challenge facing her district. While her district has made huge strides in standardized testing, school programming, and other areas, the penalty prevents them from retaining their teachers.

“The reason that impacts us is that we have very good teachers, but if you have a teacher who is offered a job for seven, eight, or ten thousand dollars more in another district, it’s not that they don’t care about your kids or your town, it’s that they gotta make a better life for their families,” Becker said.

She added that one in every three or four teachers in her district will end up moving on to other jobs. That means the school districts lose out on resources they invested in those teachers who move on, and students lose out on consistency in the classroom.

The base salary for a Slaton ISD teacher is $32,000 annually, the base salary for a teacher in nearby Lubbock ISD is $43,000.

“If the state wanted us to consolidate, I feel like they should say that we should consolidate instead of trying to punish us by being in smaller communities,” Becker said. “We are the heart beat of Texas, there are more rural communities and more small school districts than there are any other school districts.”

Becker believes that the bill Burrows has filed would change all that.

Becker said that data from the Equity Center, a school finance research and advocacy organization, suggests that reversing this penalty would give Slaton ISD enough money to offer salaries to teachers that would be competitive with nearby schools.

Numbers from Equity Center also suggest that reversing this penalty would put thousands of dollars back into school districts annually: $808,724 for Idalou ISD, $747,612 for New Deal ISD, $837,694 for Roosevelt ISD, and $820,766 for Slaton ISD.

Bills like the one Burrows has filed have been pushed through the legislature in the past, but they’ve faced some opposition.

“At the end of the day this bill has been filed by a lot of other members over a long period of time and we have not had a lot of success getting it passed,” Burrows said. “I feel like this session we need to take a hard look at school funding and I hope this is a cornerstone of re-reading the formulas.”

Burrows staff said this bill will have a modest impact on the budget, but it’s too early to know the exact numbers.

Becker plans on meeting with other educators in Region 17 to explain their concerns about the state funding penalty to State Representative Charles Perry.

“I think that it’s gonna take all of us to make a difference with this,” Becker said. “Legislators do listen to educators, but they really listen to parents and to school board members and to citizens, If citizens want a level playing field for our small rural schools, then they need to let their legislators know, whoever their legislators are.”